Pandemic Impact, Support Received, and Policies for Health Worker Retention: An Environmental Scan

Background and Objectives

The COVID-19 pandemic has brought additional strain to health workers in the Philippines, leading to a significant proportion of them leaving the workforce. The purpose of this study is to explore the impact of the pandemic on health workers, the support that they received and associated challenges; and identify relevant policies for better workplace conditions.

Methods

An environmental scanning method was utilized. Particularly, a literature review and policy scan that were validated through key informant interviews with administrators and frontline health workers from selected urban and rural sites in the three main islands in the Philippines. These were framed into a background note to springboard the discussions during a national policy dialogue participated by representatives from key government organizations, professional organizations of physicians, nurses, and midwives, professional regulatory bodies, hospital administrators, frontline health workers, and donor agencies in the Philippines.

Results

Deaths, burn-out, mental health problems, lack of personal protective equipment and poor allocation of vaccines were reported in the early phases of the pandemic. Support varied across settings but included additional allowance, free meals, accomodation, transportation, training and psychosocial services. Furthermore, pre-pandemic issues such as as low salaries and heavy workload continue to be the main reasons for leaving the workforce or the country. The proposed solutions are as follows: (1) creating policies and strategies for appropriate production, recruitment, and retention of human resources for health; (2) allocating regular permanent positions for both the education and health sector; (3) augmenting and continuation of deployment programs; (3) expanding roles of nurses to push for advanced practice nursing; (4) providing fair compensation along with risk allowances, non-financial incentives, and expanded benefits; (5) supporting mental health wellness by providing an appropriate work-rest balance and safe work environment; (6) providing opportunities for professional development and scholarships with accompanying return-service agreement; and (7) strengthening the reintegration programs for returning overseas health workers.

Conclusion

The pandemic has affected the well-being of health workers and disparities in support were reported due to longstanding workplace issues and policy implementation gaps. Stakeholder commitments require sustained monitoring while policies that are in place and yet to be developed demand stronger support from the government, members of Congress, the private sector, and other key decision-makers.

Towards Health Promoting Schools: Pilot Training and Evaluation of the Updated Urbani School Health Kit (USHK) among School Teachers in Manila

Background and Objective

Committed to enhancing healthy living, learning, and working conditions, a health-promoting school is a potent influencer of behaviors and habits, reaching families and communities effectively. In the Western Pacific region, the Urbani School Health Kit (USHK) is one of the tools developed to integrate health promotion in schools; however, it needs to be updated to adapt to the evolving health challenges of lifestyle-related diseases. Hence, this study aimed to conduct a pilot training and evaluation of the updated USHK among school teachers in Manila.

Methods

The USHK was updated with new materials on (1) health-enhancing physical activity; (2) healthy nutrition; and (3) family and community engagement. A two-day training-workshop with 30 school teachers was then conducted to facilitate the integration of the updated USHK in their class activities. We used a multi method evaluation design to assess the implementation of the USHK. Particularly, quantitative data were obtained from the participants' feedback on the toolkit and their knowledge of health-related practices. One month later, field visits were conducted to assess the participants' abilities in utilizing the toolkit into their classes or school activities. Qualitative interviews and classroom observations were also collected post-implementation to determine potential facilitators and barriers to program delivery, and suggestions for improvement. Descriptive statistics were used to summarize participant feedback, while Wilcoxon signed rank test was utilized to determine changes in participant knowledge pre- and post-training. Qualitative data were synthesized through content analysis.

Results

Participants provided high satisfaction ratings for the training they received, as well as high scores for the updated USHK, in terms of its appropriateness and acceptability. Significant improvements in participants' overall health promotion knowledge were also noted (Z = -4.456, p <0.001), particularly involving the domains of nutrition (Z = -2.972, p = 0.003), physical activity (Z = -3.564, p <0.001), and family/community engagement (Z = -2.531, p = 0.011). Meanwhile, participants also suggested further improvements in the toolkit to enhance its utilization in the local context. Administrative support was a crucial facilitator for implementing the USHK, while resource limitations were identified as significant barriers.

Conclusion

The updated USHK, which provides a more comprehensive health promotion approach for schools, is potentially feasible for implementation in educational institutions in Manila. The toolkit can be utilized by teachers and school nurses to integrate health promotion activities into the school environment and classroom activities. To facilitate its wider uptake and implementation in other schools, government support and resource availability are crucial.

Transgender Health Dilemmas: An Intersectional Analysis of the Therapeutic Itineraries of Transgender Communities in the Philippines

This study leverages an intersectional lens to characterize the therapeutic itineraries of local transgender (trans) communities vis-à-vis salient cisnormative and capitalist structures in Philippine society that produce trans health inequities. Interpretative phenomenological analysis of online interviews with thirteen (13) self-identified trans Filipinos reveals how the inaccessibility of trans-responsive care in the Philippines fosters trans health dilemmas, or the dilemmatic decision-making circumstances and processes that force trans Filipinos to choose between their trans-specific health needs and other needs. Such dilemmas valorize the deprioritization of trans health, disengagement with the health system, and the pursuit of alternative pathways to care oftentimes at the expense of their overall well-being. Addressing these dilemmas entails research, policy, and advocacy work that contend with the implicated structures of domination through systemic interventions initiated in partnership with local trans communities.

The International Breakfast Research Initiative-Evaluation and Comparison of Breakfast Nutrient Intakes in Indonesia, Malaysia and the Philippines with a View to Proposing a Harmonised Nutrient-Based Breakfast Recommendation

The International Breakfast Research Initiative is a global study of breakfast nutrition, involving 17 countries in four continents, aiming to derive nutrient-based regional recommendations for breakfast. This study aimed to propose a harmonised recommendation for three South-East Asian countries: Indonesia, Malaysia, and the Philippines. For each country, data from nationally representative dietary surveys on the contribution of breakfast to daily nutrient intakes at both the adult population level and at the level of the upper tertile of daily nutrient density using the Nutrient Rich Food (NRF) Index were collated and examined. Energy intakes at breakfast ranged from 26 to 27% of daily energy intake. In all three countries, breakfast was carbohydrate-rich, providing 52 to 72% of breakfast energy intake, while it was higher in total and saturated fat in Malaysia and Indonesia. Intakes of fibre and vitamin C were low in all countries, while Malaysia tended to have higher intakes of most minerals, including sodium. Daily and breakfast nutrient intakes (at the population level and in the upper tertile of the NRF Index) were compared to the Codex Alimentarius nutrient reference values (NRVs) to assess adequacy. A decision tree was established based on these data to guide the development of recommendations for nutrient intakes at breakfast across the three countries.

"We Need to Go Back Home (to) the Philippines Healthy": An Interpretive Phenomenological Analysis of Migrant Domestic Workers' Experiences of Having Breast Cancer in Hong Kong

Diagnoses of breast cancer are continuing to increase in the Philippines, but little is known about incidence rates among the significant number of Filipino women working abroad as migrant domestic workers (MDWs). These women are often the main income providers for their families, and their ability to work depends upon their physical health and strength. In this article, we use interpretive phenomenological analysis to explore the experiences of 10 MDWs from the Philippines who were diagnosed with breast cancer during a period of employment in Hong Kong. Analysis of these narratives revealed numerous points at which their status as temporary, transnational migrant workers intersected with their experiences of breast cancer detection, diagnosis, and treatment. We argue that these women's experiences of breast cancer were shaped by the structures of migration that link the Philippines with host destinations like Hong Kong. These structures create a unique context in which these women had to constantly renegotiate their identities as migrants, financial providers, and breast cancer patients.

ChemsexPH: The association between chemsex, HIV status and adherence to antiretroviral therapy among men who have sex with men in the Philippines

INTRODUCTION

Chemsex, the use of psychotropic drugs before or during sexual intercourse, is associated with various HIV risk factors, including condomless sex and reduced adherence to pre-exposure prophylaxis or antiretroviral therapy (ART). In the Philippines, there are still limited studies exploring the associations between chemsex, HIV status and ART adherence. This study aims to compare recent and lifetime chemsex engagement in association with self-reported HIV status among Filipino men who have sex with men (MSM). We further explored the association between chemsex and ART adherence among people living with HIV engaged in chemsex.

METHODS

A cross-sectional online survey of 479 Filipino MSM was conducted from 3 August to 1 December 2019. Demographic profiles, sexual behaviours, drug use, history of sexually transmitted infections (STIs), chemsex engagement and HIV status were collected and analysed. Bivariable and multivariable logistic regression were employed to assess the association between self-reported HIV status and chemsex engagement.

RESULTS

Among the 479 respondents, Filipino MSM engaged in drug use and chemsex were generally older compared to those not engaged in drug use and chemsex (average age 31-33 vs. 29 years old; p<0.05). Methamphetamine was the most common drug for people who reported using drugs. An HIV-positive status was associated with recent chemsex engagement (aOR = 5.18, p<0.05) and a history of STIs (aOR = 2.09, p<0.05). The subgroup analysis showed that 79% (166/200) of persons living with HIV were adherent to ART. There was no significant association found between chemsex and ART adherence in the logistic regression analyses.

CONCLUSIONS

Chemsex behaviour, particularly recent chemsex engagement, is significantly associated with self-reported HIV status. The emerging data on MSM engaged in chemsex require integration of a more person-centred, comprehensive and robust harm reduction programmes into the existing combination prevention strategies in the country. Health education for Filipino MSM engaged in chemsex should prioritize raising awareness about methamphetamine effects and overdose risks, alongside proper medical management.

Filipino Immigrants in Santa Cruz de Tenerife, Spain: Health and Access to Services

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access.

Psychometric validity and measurement invariance of the caring for Bliss Scale in the Philippines and the United States

The Caring for Bliss Scale (CBS) is a new measure that assesses an individuals' capacity to cultivate inner joy and happiness. Developed in the United States, its generalizability remains unknown in non-Western contexts. This research explored the scale's cross-national invariance among college students in the Philippines (n = 546) and the United States (n = 643). A multi-group confirmatory factor analysis using maximum likelihood estimation showed that the unidimensional model of caring for bliss exhibited configural, metric, scalar, and residual invariance across the Filipino and the U.S. samples. This scale also had good internal consistency estimates in both settings. In both contexts, caring for bliss was positively correlated with well-being and negatively correlated with different negative quality of life indicators (i.e., stress, anxiety, and depression). This study offered preliminary evidence regarding the cross-national applicability of the CBS in different cultural settings during the COVID-19 pandemic.

Barriers and enablers to people-centred viral hepatitis care in Vietnam and the Philippines: Results of a patient journey mapping study

In Vietnam and the Philippines, viral hepatitis is the leading cause of cirrhosis and liver cancer. This study aims to understand the barriers and enablers of people receiving care for hepatitis B and C to support both countries' efforts to eliminate viral hepatitis as a public health threat by 2030. Retrospective, semi-structured interviews were conducted with a purposive, quota-based sample of 63 people living with hepatitis B or C in one province of Vietnam and one region of the Philippines. A rapid deductive approach to thematic analysis produced key findings among the three phases of care: (1) pre-awareness and testing, (2) linkage and treatment initiation and (3) ongoing treatment and recovery. The research found that participants followed five typical journeys, from a variety of entry points. Barriers during the pre-awareness and testing phase included limited awareness about hepatitis and its management, stigma and psychological impacts. Enablers included being familiar with the health system and/or patients benefiting from social connections within the health systems. During the linkage and treatment initiation phase, barriers included difficult physical access, complex navigation and inadequate counselling. In this phase, family support emerged as a critical enabler. During the ongoing treatment and recovery phase, the cost of care and socially and culturally informed perceptions of the disease and medication use were both barriers and enablers. Exploring peoples' journeys with hepatitis B and C in Vietnam and the Philippines revealed many similarities despite the different cultural and health system contexts. Insights from this study may help generate a contextualized, people-centred evidence base to inform the design and improvement of primary care services for hepatitis in both research sites.

Integrating science-based and local ecological knowledge: a case study of mangrove restoration and rehabilitation projects in the Philippines

Mangrove forest is an ecosystem-based solution for disaster risk reduction in the Philippines, but its historical deforestation has hampered its capacity to protect coastal communities. With the increasing occurrence of storm surge in the Philippines, mangrove reforestation projects have received renewed attention, but many have failed. Community participation was deemed to be essential in those projects that did well. Hence, this paper examines successful mangrove restoration and rehabilitation projects in the Philippines to find out how community participation contributed to the accomplishments. The study found that while the transfer of science-based ecological knowledge from project managers to the community is an important factor in ensuring successful initial planning and implementation, its integration into existing local ecological knowledge-'localisation' of science-based ecological knowledge or hybrid ecological knowledge formation-helped to facilitate long-term community-based mangrove management beyond project duration by empowering community members and enabling project acceptance and ownership. Still, continuous local institutional support is a necessary anchor for community resilience.

Nurses-Led Municipal Leadership and Governance Program: Experiences of Local Chief Executives in Central Visayas, Philippines

Background

The strategic response of nurses in addressing health inequities in marginal sectors led to the conduct of a health leadership governance training program for local chief executives.

Objective

This study aimed to explore and provide a description of the experiences of local chief executives (LCEs) or mayors who participated in the nurse-initiated health training named Municipal Leadership and Governance Program (MLGP).

Methods

A qualitative descriptive design was used through key informant interviews of fifteen mayors or local chief executives (LCE) in the provinces of Bohol and Negros Oriental, Philippines. Data were collected from 16 to 20 November 2022 and analyzed using a thematic approach.

Results

The findings generated six themes: a) Leadership capacitation promoting transformative experience, b) Pandemic and program-induced limitations in the training implementation, c) Personal leadership motivation, d) Experiential learning promoting learning as applied in real-world situations, e) Celebrating leadership transformation, and f) 3R's of MLGP: revisit, review, recommend.

Conclusion

The realizations of the training participants provided valuable implications for the quality of training offered by nurse leaders who advocated the MLGP implementation. It served as a proactive and responsive approach to the health leadership capacitation of mayors. It guided them in their personal realizations that inspired them to apply what they had learned and enabled them to effect experiences of personal to institutional transformation.

Nursing students' lived experiences with using AIDET in patient communication: A qualitative study in the Philippines

Background

Effective communication is vital in nursing, influencing patient safety, satisfaction, and care quality. The AIDET framework is a proven tool for reducing patient anxiety and enhancing their experience. However, perceptions and experiences of Filipino nursing students with AIDET remain unexplored.

Objective

This study explored Filipino nursing students' use of AIDET, focusing on benefits, challenges, and improvements.

Methods

A qualitative, interpretive phenomenological approach informed by the philosophy of Martin Heidegger was employed. This 2023 study, conducted at a university in Angeles City, Philippines, explored Filipino nursing students' experiences with the AIDET communication framework. Thirty participants were purposefully selected to participate in facilitated discussions following a semi-structured interview guide. Thematic content analysis of the transcribed audio recording identified recurring themes in their narratives, focusing on the meanings they ascribed to their experiences using AIDET.

Results

Four themes emerged: (a) Streamlined nurse-patient interaction (organizes communication, rapport building, alleviate anxiety, acknowledgment, and empowerment as sub-themes), (b) Enhances patient-centered care (empathy and compassion, improved patient experience as sub-topics), (c) Challenges with specific patient populations (patient preferences, language barrier, patient condition, acknowledgment of cultural differences as sub-themes), and (d) AIDET in nursing education strengthening application through practice, optimizing frequency and timing, promoting deeper understanding, enhancing feedback mechanism) as student nurses' recommendations.

Conclusion

Early integration of AIDET in nursing education is essential for student nurses to enhance communication, improve patient satisfaction, and deliver patient-centered care, equipping them with valuable communication skills.

Bayesian phylogenetic analysis of Philippine languages supports a rapid migration of Malayo-Polynesian languages

The Philippines are central to understanding the expansion of the Austronesian language family from its homeland in Taiwan. It remains unknown to what extent the distribution of Malayo-Polynesian languages has been shaped by back migrations and language leveling events following the initial Out-of-Taiwan expansion. Other aspects of language history, including the effect of language switching from non-Austronesian languages, also remain poorly understood. Here we apply Bayesian phylogenetic methods to a core-vocabulary dataset of Philippine languages. Our analysis strongly supports a sister group relationship between the Sangiric and Minahasan groups of northern Sulawesi on one hand, and the rest of the Philippine languages on the other, which is incompatible with a simple North-to-South dispersal from Taiwan. We find a pervasive geographical signal in our results, suggesting a dominant role for cultural diffusion in the evolution of Philippine languages. However, we do find some support for a later migration of Gorontalo-Mongondow languages to northern Sulawesi from the Philippines. Subsequent diffusion processes between languages in Sulawesi appear to have led to conflicting data and a highly unstable phylogenetic position for Gorontalo-Mongondow. In the Philippines, language switching to Austronesian in 'Negrito' groups appears to have occurred at different time-points throughout the Philippines, and based on our analysis, there is no discernible effect of language switching on the basic vocabulary.

Sensing, knowing, and making water quality along Marikina River in the Philippines

Water quality is a major concern around the world, but assessments of quality often privilege producers, regulators and experts over consumers. With water supplies and sources constantly in flux, how do ordinary people experience and "sense" quality? How do they define "good" or "good enough" water, and what practices do they engage in to "make" good water? In this article, we attend to these questions by presenting findings from an open-ended qualitative study carried out along the Marikina River, Manila, the Philippines - a waterway that courses from rural and mountainous villages to highly urbanized communities. First, we describe the sensorial and cognitive attributes that people associate with the different water sources in their environment, as well as their decision-making regarding what kind of water to use for which purposes. Second, we present the "making" of water quality: how, in a context of polluted environments and water scarcity, do people try to secure water they consider acceptable for themselves and their families. Our findings reveal water quality as a contested, relational domain-one that reinforces social and health disparities and calls for further scholarship.

Stiphodon chlorestes, a new species of sicydiine goby (Teleostei: Gobioidei) from Taiwan and Luzon

Stiphodon chlorestes sp. nov. is described based on seven specimens collected from Taiwan and Luzon. It is a large-sized Stiphodon species sharing the second dorsal-fin rays 9-10 and pectoral-fin rays 14-16 with similar-sized congeners. However, it differs from them by the wider interorbital width and almost complete lack of scales on the occipital region in males. In addition, the new species can be further distinguished from all congeners by seven to eight oval bands or a black longitudinal band on the lower body, black and white spots on pectoral fins, and a short red or orange line on posterior upper edge of caudal fin. Molecular analysis based on the 680-bp mitochondrial cytochrome oxidase subunit I (COI) fragments also supports it as a distinct species belonging to the "Stiphodon elegans group" and a sister group of the clade consisting of Stiphodon multisquamus and Stiphodon palawanensis.

Drivers of Anemia Reduction among Women of Reproductive Age in the Philippines: A Country Case Study

BACKGROUND

Anemia prevalence among women of reproductive age (WRA) in the Philippines was 25% in 2000, decreasing to 13% in 2018. To date, an in-depth assessment of the determinants associated with this decline has not been conducted.

OBJECTIVE

To conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in the Philippines between 2008 and 2018.

METHODS

Employing standard Exemplars methodology, we conducted quantitative analyses using the Philippines' National Nutrition Survey, the Expanded National Nutrition Survey, and the Philippines National Demographic and Health Surveys. Qualitative analyses included a comprehnsive literature review, program/policy analysis, and interviews with stakeholders to understand country-level enablers and barriers to WRA anemia decline in the Philippines. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors.

RESULTS

Among non-pregnant women (NPW), mean hemoglobin (Hb) increased from 12.7 g/dL in 2008 to 13.1 g/dL in 2018 (p<0.01), corresponding to an 11%-point decline in anemia prevalence (23% to 12%). Inequities by geographical region, household wealth, and women's educational attainment narrowed considerably during this time. Important direct and indirect nutrition programs were introduced during our study period, including universal healthcare and food fortification. Country experts interviewed credited programs focused on alleviating micronutrient deficiencies and poverty, and improvements in women's health and well-being, for the country's extraordinary success. OBDA explained ∼50% of the observed change in mean Hb among NPW, with family planning (35%), household socio-demographics (29%), and improvement in women's nutrition (23%) emerging as critical drivers of anemia decline, corroborating our qualitative and policy analyses.

CONCLUSIONS

To protect these gains, WRA anemia prevention efforts in the Philippines should continue to focus on universal healthcare access, women's empowerment, and poverty alleviation.

African Swine Fever in the Philippines: A Review on Surveillance, Prevention, and Control Strategies

African swine fever (ASF), a highly contagious disease of swine, has posed a significant global threat to the swine industry. As an archipelago, the Philippines has a geographic advantage when it comes to the risk of ASF transmission. However, since its introduction to the Philippines in 2019, it has proliferated not only in backyard and commercial farms but also in wild pig populations. While certain parts of the country were more affected than others, the epidemiologic features of ASF necessitate that all affected areas must be closely monitored and that confirmed cases be treated with the utmost care. With the very limited data on ASF epidemiology and surveillance in the Philippines, future efforts to combat ASF must place even greater emphasis on improved prevention and control strategies. It is worth mentioning that the government's efforts toward comprehensive ASF surveillance and epidemiological investigation into the possible ASFV sources or transmission pathways are the most important measures in the prevention and control of ASF outbreaks. This review article provides a comprehensive overview of the current swine industry and ASF situation in the Philippines, which includes its epidemiology, surveillance, prevention, and control strategies.

Impacts of rainfall and rainfall anomalies on the population dynamics of rodents in southeast Asian rice fields

BACKGROUND

The mechanisms that regulate multi-annual population dynamics of rodent pest species of cereal crops is often unknown. Better knowledge of such aspects can aid pest management and in turn improve food security and human health. The patterns and processes of the population dynamics of Rattus argentiventer, in rice fields of Indonesia, and Rattus tanezumi, in rice fields of the Philippines were assessed in this article.

RESULTS

The meta-analysis of trapping data over 20 years in Indonesia, and 16 years in the Philippines indicated that rodent populations in rice fields did not show a regular multi-annual pattern. Rattus argentiventer populations in Indonesia responded to less rainfall from the current year. Rattus tanezumi populations in the Philippines responded positively to both rainfall and rainfall anomaly with a 1-year time lag.

CONCLUSIONS

Our study of long-term population data indicates that certain combinations of rainfall parameters could be useful to predict years when there is higher rodent abundance in rice fields. The key rodent pest species in rice fields in Indonesia (R. argentiventer) and the Philippines (R. tanezumi) differ, and the populations of each species respond differently to rainfall anomalies. Other factors such as crop cover and water availability may also be important and should be considered in future work. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Patient Profiles and Cost of Otolaryngologic Surgeries in an LMIC Country

Objectives

This study aims to analyze the cost of patient care among ORL-HNS patients admitted in a tertiary, teaching government hospital in a low- to middle-income country.

Methods

This is a prevalence-based, prospective, bottom-up, cost-of-illness analysis among patients of the Department of Otorhinolaryngology-Head and Neck Surgery in a tertiary training government hospital admitted from July 2021 to March 2022. The value assessment method used is the human capital approach. The societal perspective is used for analysis to estimate and reflect payer (insurance providers) and patient perspectives.

Results

A total of one hundred fifty seven (157) patients were admitted for elective surgery under the service of ORL-HNS consisting of 75 females and 82 males. The average total overall cost was $3,851.10 (Php 199, 870.50 ± 164, 725.60). The total direct health care cost for all patients within the study period amounted to $3,712.18 (Php 192, 662.22 ± 159, 548.60) while the direct non-health care cost was $58.60. The workforce cost (58.5%) and medication cost (18.8%) comprised the majority of in-patient expenses with a mean cost of $2,221.36 (Php 37,083.66) and $714.51 (Php 44,363.14), respectively. In this study, an average of $80.29 was lost due to illness and hospitalization (± $81.74). The total PHIC coverage pays a range from zero to 67.5% with an average coverage of only 17%.

Conclusion

Our analysis has shown that workforce and medication expenses are the main cost drivers for the direct healthcare costs among Otolaryngology patients admitted for elective procedures. Stakeholders, such as the otolaryngologists and hospitals should coordinate closely to create a more encompassing coverage of Philhealth to prevent patients from suffering from financial crises due to their illness.

Fostering LGBTQ+ Mental Health Promotion in Non-Health Academic Programs: A Filipino Perspective

This article emphasized the urgency of promoting LGBTQ+ mental health in the Philippines, a nation known for its friendly attitude toward LGBTQ+ individuals. Despite this, a significant portion of the population maintains negative attitudes, fostering persistent stigmatization and discrimination against gay men and lesbians. These adverse social conditions, coupled with the absence of comprehensive LGBTQ+ rights protection, exacerbate mental health disparities among LGBTQ+ individuals. Recognizing the pivotal role of educational institutions, this article explores the integration of an elective course, "LGBT+ Mental Health," within an applied behavioral science program. The curriculum was based on international reports and local studies, employing frameworks like Minority Stress and Intersectionality to scrutinize factors influencing LGBTQ+ mental health disparities. The course's blended approach encourages student engagement through discussions, group work, and assessments. Insights from the course reveal students' capacity to develop organizational programs and policies that promote mental health and inclusivity. Recommendations include expanding LGBTQ+ mental health integration beyond health-related degrees, providing support and resources, fostering a cultural shift toward acceptance within educational institutions, and tailoring the course to better respond to local LGBTQ+ needs. Moreover, the paper emphasizes the critical role of educational institutions in addressing LGBTQ+ mental health disparities, serving as a model for future progress and inclusivity. Overall, this integration of LGBTQ+ mental health promotion in a non-health academic degree program can serve as a model for institutions to advance the well-being of LGBTQ+ individuals and dismantle systemic barriers.

One health in the Philippines: A review and situational analysis

The Philippines faces a complex and interconnected web of human, animal, and environmental health issues, including zoonotic and reverse zoonotic diseases, antimicrobial resistance, food insecurity and contamination, and threats from environmental degradation. This paper examines these issues, existing interventions, and their implementation challenges. The overall framework used to analyze the level of operationalization of the One Health approach is the Multi-sectoral One Health Coordination Framework developed by the World Health Organization, Food and Agriculture Organization, and the World Organization for Animal Health. A two-step process was conducted: literature review, followed by consultations with government and non-government stakeholders across national, subnational, and local levels. There has been significant progress in laying the foundation for collaboration between the human, animal, and environmental sectors. These are demonstrated by the presence of structures and systems, including inter-agency task forces, emergency response plans and mechanisms, and a network for health human resources. However, these are eclipsed by challenges, including the limited governance mechanisms within inter-agency committees, fragmented risk assessment and surveillance, untapped opportunities for joint investigation and response, insufficient resources for capacity-building, and absence of comprehensive risk communication and community engagement initiatives. These challenges highlight the importance of promoting multi-sectoral governance and ensuring resource allocation and sharing. Joint activities across risk assessment, surveillance, investigation, and response are critical in ensuring a proactive and holistic approach to addressing threats. A well-capacitated interdisciplinary workforce, not only capable of managing these hazards but also empowering communities to protect themselves, is necessary in ensuring innovation and collaboration on health risks at the human-animal-environment interface. In light of the multifaceted challenges faced by the Philippines, the One Health approach emerges as a vital strategy. By addressing governance issues, enhancing coordination, and bolstering resource allocation, the country can better protect the health and well-being of its people, animals, and ecosystems.

Integrative Review of Workplace Health Promotion in the Business Process Outsourcing Industry: Focus on the Philippines

Objective

The Business Process Outsourcing (BPO) industry in the Philippines has experienced substantial growth, making a significant contribution to the country's economy. However, concerns about work-related health and safety issues have emerged, necessitating effective workplace health promotion strategies for BPO employees.

Study design

An integrative review of relevant literature was conducted to explore workplace health promotion in the BPO sector.

Methods

The search included quantitative, qualitative, and mixed-method studies, pertinent laws, policies, news articles, and reports published between 2000 and 2022. The scope was intentionally broad to encompass a diverse range of relevant evidence related to workplace health in this field. Articles published both in the English and Filipino languages were considered.

Results

Findings revealed that BPO workers face risks related to physical and psychological stress, sleep disturbances, and occupational diseases owing to the unique challenges inherent to the nature of their jobs. While there are existing occupational health and labor laws, compliance among BPO companies remains a problem, and only a few organizations offer comprehensive wellness programs. Building upon the available evidence, a conceptual framework was developed to provide guidance for enhancing workplace health promotion initiatives specifically designed for BPOs in the country.

Conclusion

Workplace health promotion is vital to warrant the health and safety of BPO workers. This study offers evidence-based recommendations for implementing effective well-being strategies, highlighting the importance of collaboration among employers, employees, and society to prioritize employee health in the workplace.

Online sexual abuse and exploitation of children in the Philippines: An exploratory study of outcomes after reintegration into the community

BACKGROUND

This study examined psychosocial outcomes for Filipino survivors of online sexual abuse and exploitation of children (OSAEC).

OBJECTIVE

This study aimed to identify relationships between demographic variables, self-reported and caregiver-reported trauma symptoms, and psychosocial functioning among Filipino youth who have experienced OSAEC.

PARTICIPANTS AND SETTING

This study utilized inclusion criteria of survivors of OSAEC between ages 12 and 18 who received residential care and were reintegrated into the community for at least one year (N = 48). Participants were in care at shelters associated with Project PAVE in the Philippines.

METHODS

As measured by three assessment tools, relationships between demographic variables and psychosocial functioning were explored for risk and protective factors of trauma symptoms and psychosocial functioning to better understand this population's needs post-integration.

RESULTS

Results suggest survivors continue to experience psychosocial symptoms after reintegration. Caregivers reported survivors reintegrated outside the home had significantly higher externalizing symptoms (MR = 6.67; H(3) = 14.85, p = .002, η2 = 0.27) compared to survivors reintegrated within the home and survivors who trafficked themselves to have higher internalizing symptoms (MR = 16.79; H(3) = 11.80; p = .008, η2 = 0.20) than survivors trafficked by a relative. Caregivers reported survivors who resided in the shelter for one month or less to have higher internalizing symptoms (MR = 20.12; H(2) = 11.06; p = .004; η2 = 0.20) than survivors who resided in the shelter for six months or longer.

CONCLUSION

This study highlights the importance of further research to better understand the needs of this vulnerable population in order to guide the most effective intervention, aftercare, and reintegration programs to support survivors and their caregivers.

Her village: experiences of drug-involved women in a female-only aftercare program in the Philippines

PURPOSE

Women are exposed to vulnerabilities that can lead to drug use or hinder recovery. However, there is a dearth of studies on recovery programs for women. This study aims to add to the literature by examining the feasibility of a women-only aftercare program for recovering users in the Philippines.

DESIGN/METHODOLOGY/APPROACH

The study used a mixed-method design with pre and post-program surveys used to measure changes in participants' recovery capital. Focused group discussions elicited participants' context, their reactions, perceived outcomes and suggestions on the program.

FINDINGS

Women in the program shared narratives of pain, trauma and abuse before treatment. Participants reported significant improvements in personal, community and family recovery capital dimensions. The program enabled personal growth in the form of new knowledge, skills and self-confidence. The women-only program also provided a safe space for women, to receive support from other women, community members and family. However, the women continue to face continuing challenges related to stigma and discrimination and a lack of livelihood opportunities.

RESEARCH LIMITATIONS/IMPLICATIONS

A limitation of the study was its small sample size and the lack of a control group. Another limitation was the variability in treatment received by the women, which could have affected overall outcomes. Future studies using a randomized control trial and longitudinal designs may provide more robust conclusions on the effectiveness of the program.

PRACTICAL IMPLICATIONS

Given punitive contexts, gender-sensitive and trauma-informed programs and services for women involved in drug use could potentially mitigate the abuse, stigma and vulnerabilities they experience.

ORIGINALITY/VALUE

This study contributes to the sparse literature on women-only aftercare, particularly in countries that criminalize drug use.